International Major Medical Insurance | Benefits

The Global Medical Insurance plan provides you with five plan levels to choose from: Bronze, Silver, Gold, Gold Plus and
Platinum. Each level of the plan offers different coverage benefits and amounts, so depending on your insurance
needs there should be a plan that works for you.

We also encourage you to contact our customer support team who will be able to assist you
with finding the correct plan to fit your needs, we can also explain the plan levels in greater detail.

Optional Vision & Dental Rider*

$750 max per period of coverage; $50 individual deductible, applies to minor restorative and major restorative services

Vision

Optional Vision & Dental Rider*

Exams – up to $100 per 24 months for Routine Eye Exam
Materials – up to $150 per 24 months

Exams: up to $100 max per 24 months
Materials: up to $150 max per 24 months

Hospital Indemnity
(Outside the U.S. only)

Private Hospital: $400 per overnight and $4,000 max. per period of coverage
Public Hospital: $500 per overnight and $5,000 max. per period of coverage
Not subject to deductible or coinsurance

Pre-existing Conditions

Pre-existing condition coverage is excluded from the Bronze level of the plan. On the Silver, Gold, Gold Plus, and Platinum plan options, conditions that are fully disclosed on the application and have not been excluded or restricted by a rider will be covered the same as any illness. Conditions, including any complications therefrom, that are known and not fully disclosed on the application will not be covered.

On the Silver, Gold, Gold Plus, and Platinum plan options, unknown pre-existing conditions that existed at or prior to the effective date can be covered after 24 months of continuous coverage. These levels will provide a $50,000 lifetime benefit for eligible pre-existing conditions, subject to a maximum of $5,000 per period of coverage.

The following illnesses which existed, manifest themselves, or are treated, or have treatment recommended prior to or during the first 180 days of coverage from the initial effective date are considered pre-existing conditions and are subject to the waiting period and other limitation of coverage described above: acne, asthma, allergies, tonsillectomy, back conditions, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders or the reproductive system, hysterectomy, hernia, gall bladder or gall stones and kidney stones, any condition of the breast, and any condition of the prostate.

The above is a summary schedule of benefits. Benefits are subject to the deductible and coinsurance unless
otherwise noted. NA (Not Applicable); URC (Usual, Reasonable and Customary); SAAI (Same As Any Illness). For a
further description of benefits, please refer to the Global Medical Brochure.